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Prognostic importance of pretransplant disease status for posttransplant outcomes in patients with adult T cell leukemia/lymphoma

Bone Marrow Transplantation volume 53, pages 1105–1115 (2018)Cite this article

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Abstract

Adult T cell leukemia/lymphoma (ATL) is an aggressive T cell lymphoma with a poor prognosis. Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be a curative treatment for ATL, a significant proportion of allo-HSCT recipients suffer from relapse/progression of ATL. Here we aimed to clarify the risk factors for and outcomes after posttransplant relapse/progression. We retrospectively reviewed 76 patients with ATL who received allo-HSCT at our institute. At the time of allo-HSCT, disease status was complete response in 17 patients, partial response in 29, stable disease (SD) in 18, and progressive disease (PD) in 12. In multivariate analysis, SD/PD at allo-HSCT, lymphoma subtype, reduced-intensity conditioning regimen, and time from diagnosis to allo-HSCT were associated with risk of relapse/progression. After allo-HSCT, 26 patients had relapse/progression at a median of 66 days (range, 13–2064 days). The 2-year overall survival rate after relapse/progression was only 19%. Compared with acute-type, lymphoma-type experienced local recurrence more frequently (1/15 acute vs. 7/11 lymphoma, P < 0.01) and had a significantly longer OS after relapse/progression (median; 112 days in acute vs. 554 days in lymphoma, P < 0.01). Since the prognosis of patients with ATL who experienced relapse/progression after allo-HSCT was poor, strategies to reduce the risk of these outcomes are warranted.

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Acknowledgements

This research was partially supported by the Practical Research for Innovative Cancer Control program of the Japan Agency for Medical Research and Development (15Ack0106136h0002) and by the National Cancer Research and Development Fund (26-A-26).

Author contributions

YI, SF, and TF participated in research design, data analysis, and writing of the paper. RT, YI, TT, AI, KO, SK, S-WK, and HN participated in writing of the paper. All authors approved the submission of this study.

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Authors and Affiliations

  1. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Yoshitaka Inoue, Shigeo Fuji, Yoshihiro Inamoto, Takashi Tanaka, Ayumu Ito, Keiji Okinaka, Saiko Kurosawa, Sung-Won Kim & Takahiro Fukuda

  2. Department of Hematology, Kumamoto University Hospital, Kumamoto, Japan

    Yoshitaka Inoue

  3. Juntendo University Graduate School of Medicine, Tokyo, Japan

    Yoshitaka Inoue & Shigeo Fuji

  4. Department of Hematology, Osaka International Cancer Institute, Osaka, Japan

    Shigeo Fuji

  5. Department of Blood Transfusion and Cellular Therapy, National Cancer Center Hospital, Tokyo, Japan

    Ryuji Tanosaki

  6. Center for Transfusion Medicine and Cell Therapy, Keio University School of Medicine, Tokyo, Japan

    Ryuji Tanosaki

  7. National Cancer Center, Tokyo, Japan

    Hitoshi Nakagama

Authors
  1. Yoshitaka Inoue
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  2. Shigeo Fuji
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  11. Takahiro Fukuda
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Correspondence to Shigeo Fuji.

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Inoue, Y., Fuji, S., Tanosaki, R. et al. Prognostic importance of pretransplant disease status for posttransplant outcomes in patients with adult T cell leukemia/lymphoma. Bone Marrow Transplant 53, 1105–1115 (2018). https://doi.org/10.1038/s41409-018-0139-z

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